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Because no available evidence supports the use of over-the-counter decongestants and antihistamines in young children with the common cold, and the safety of these medications remains uncertain, the authors of an editorial published today Tea BMJ Pediatric patients are encouraged to use these products in their pediatric patients.
Instead, the authors suggest reassuring patients and parents that these diseases are self-limiting, and symptoms will resolve without treatment.
"Some products that contain decongestant may improve nasal symptoms in children, but their safety, especially in young children, is unclear," Mieke L. van Driel, MD, PhD, MSc, chair in general practice at the University of Queensland, Australia, and colleagues wrote. "We did not find evidence to support the use of other remedies in children, such as humidified air or steam, analgesics, echinacea, probiotics, herbs or vitamins."
To support their position, which includes drowsiness, gastrointestinal upset, convulsions, rapid heart rate, and death.
This is especially important because of the experience of six and eight colds annually. Van Driel and colleagues noted that this is a problem that can not be avoided.
Experts said that there is no evidence to support the use of OTC decongestants and antihistamines in children with the common cold. Instead, providers should reassure patients that these illnesses are self-limiting.
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For children aged 12 years, some low-quality evidence to saline irrigations being safe and possibly effective in young children. Other treatments, including decongestants and antihistamines, have been reported in the literature. Furthermore, using aromatic rubs to relieve congestion may result in skin rashes.
Currently, 17 clinical trials are evaluating medications and remedies to treat the common cold in children. These include analgesic-decongestant-antihistamine combinations (n = 3), intranasal decongestant (n = 1), Chinese (n = 3) or other herbs (n = 4), herbal steam inhalation (n = 1), and lactic acid bacteria (n = 1), pelargonium (n = 1), guaifenesin (n = 1) and antivirals (n = 2), according to the authors. These trials predominantly focus on adults, with four trials focused only on children and adults.
"Explain that a cold is distressing but should pass in 7 to 10 days," van Driel and colleagues wrote. "If parents are concerned about their child's comfort, nasal saline irrigations may be given to alleviate nasal symptoms." by Katherine Bortz
Disclosures: van Driel reports payment from IN VIVO Academy Ltd. to develop a policy for the treatment of an epidemic by a competitive unrestricted grant from Pfizer. Please see the editorial for all other authors' relevant financial disclosures.
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